Sports Hernia Diagnosis: The Tests Every Clinician Should Know

By dpope2020

July 30, 2026

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Sports Hernia Diagnosis: The Tests Every Clinician Should Know

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In today's video we go over Sports Hernia Diagnosis: The Tests Every Clinician Should Know:

Struggling to pin down the exact source of your patient’s nebulous groin pain? Tired of second-guessing whether it's a sports hernia, adductor strain, or a core muscle injury?

Groin injuries are notoriously frustrating for both clinicians and patients. When athletes walk into your clinic with deep pubic discomfort, pain with kicking, or mysterious abdominal symptoms, a vague diagnosis leads to poor rehab outcomes.

In this video, we'll break down a clear, evidence-based framework to accurately diagnose athletic pubalgia (commonly known as a sports hernia or core muscle injury). Based on the 2015 Doha Agreement and recent literature like Pürckhauer et al. (2020), you'll learn how to systematically rule in and differentiate specific buckets of athletic groin pain.

What You Will Learn in This Video:

✅ Subjective Assessment: Key red flags, patient presentation, and provocative movements (like kicking and valsalva).

✅ Adductor-Related Pain: How to accurately palpate the adductor longus and perform resisted adduction testing.

✅ Psoas-Related Pain: Step-by-step palpation boundaries relative to the ASIS and specific resisted flexion/stretch tests.

✅ Inguinal & Pubic-Related Pain: Identifying pain along the inguinal canal, handling neural involvement, and testing for core muscle integrity.

✅ Advanced Special Tests: Executing the resisted cross-body sit-up, straight leg sit-up, and external rotation Stinchfield test.

TIMELINE

  • 0:00 - Intro to Athletic Pubalgia & The Doha Agreement (2015)
  • 1:15 - Target Populations & Subjective Patient History (Gradual Onset, Sports Involved)
  • 2:15 - Objective Exam: Adductor-Related Pain & Palpation
  • 4:20 - Psoas-Related Pain Assessment & Special Tests
  • 5:31 - Inguinal-Related Pain & Valsalva/Cough Testing
  • 6:34 - Core Muscle Injury Tests
  • 8:04 - Assessing for Adductor Contractures & Next Steps (FAI)

My hernia is sporty,

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Kurowicki J, Kraeutler MJ, Dávila Castrodad IM, Hahn AK, Simone ES, Kelly MA, Talishinskiy T, Scillia AJ. Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury. Am J Sports Med. 2020 Jul;48(8):1983-1988. doi: 10.1177/0363546520926029. Epub 2020 Jun 8. PMID: 32510969.
  2. BOYAJIAN-O'NEILL, L. A., KIBLER, W. B., O’CONNOR, F. G., INDELICATO, P. A., PUTUKIAN, M., SUTTON, K., FRANKS, R. R., ROACH, R., STATUTA, S. M., POWELL, A., SAFRAN, M., HUTCHINSON, M., HERRING, S. A., & CHANG, C. J. (2023). Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement. Medicine & Science in Sports & Exercise, 56(3), 385–401. https://doi.org/10.1249/MSS.0000000000003324
  3. Forlizzi JM, Ward MB, Whalen J, Wuerz TH, Gill TJ 4th. Core Muscle Injury: Evaluation and Treatment in the Athlete. Am J Sports Med. 2023 Mar;51(4):1087-1095. doi: 10.1177/03635465211063890. Epub 2022 Mar 2. PMID: 35234538.
  4. Drager J, Rasio J, Newhouse A. Athletic Pubalgia (Sports Hernia): Presentation and Treatment. Arthroscopy. 2020 Dec;36(12):2952-2953. doi: 10.1016/j.arthro.2020.09.022. PMID: 33276883.